Individual
TODD OTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2525 GLENN HENDREN DR, LIBERTY, MO 64068-9625
(816) 781-7200
(816) 792-7196
Mailing address
PO BOX 804408, KANSAS CITY, MO 64180-4408
(816) 792-7126
(816) 792-7196
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
104599
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
104599
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
912680303
—
MO
Enumeration date
03/22/2006
Last updated
08/21/2013
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